Pediatrics
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Randomized Controlled Trial Comparative Study
Hemodynamic effects of delayed cord clamping in premature infants.
Delayed cord clamping (DCC) has been advocated during preterm delivery to improve hemodynamic stability during the early neonatal period. The hemodynamic effects of DCC in premature infants after birth have not been previously examined. Our objective was to compare the hemodynamic differences between premature infants randomized to either DCC or immediate cord clamping (ICC). ⋯ DCC in premature infants is associated with potentially beneficial hemodynamic changes over the first days of life.
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The goal of this study was to evaluate parents' capability to assess their febrile child's severity of illness and decision to present to the emergency department. We compared children referred by a general practitioner (GP) with those self-referred on the basis of illness-severity markers. ⋯ Although febrile self-referred children were less severely ill than GP-referred children, many parents properly judged and acted on the severity of their child's illness. To avoid delayed or missed diagnoses, recommendations regarding interventions that would discourage self-referral to the emergency department should be reconsidered.
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Randomized Controlled Trial Comparative Study
Effect of repeated dietary counseling on serum lipoproteins from infancy to adulthood.
As atherosclerosis is a lifelong process, prevention of exposure to its risk factors should start at an early age. Our aim was to study the influences of repeated low saturated fat dietary counseling on dietary intakes and lipoprotein measures from infancy to adulthood. ⋯ Repeated dietary counseling is effective in decreasing saturated fat intake and serum LDL-C values from infancy until 19 years of age in both genders. In boys, significant intervention effects are evident in various lipoprotein measures, indicating a more favorable lipid profile in the counseling group.
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Comparative Study
Changing epidemiology of bacteremia in infants aged 1 week to 3 months.
Bacteremia in young infants has remained an important ongoing concern for decades. Despite changes in prenatal screening and infant immunizations, the current epidemiology of this problem has received little attention. ⋯ Our study indicates bacteremia in young infants occurs infrequently and in only 2.2% of those who had a blood culture drawn. On the basis of the epidemiology of pathogens found in this large cohort, these data suggest a change in currently recommended presumptive antibiotic coverage in 1-week to 3-month-old infants with suspected bacteremia.
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Comparative Study
Discharged on supplemental oxygen from an emergency department in patients with bronchiolitis.
Bronchiolitis is the most common reason for hospital admission in patients aged <1 year. Admissions have been increasing with hypoxia frequently cited as the determinant. Home oxygen (O(2)) has been shown to be feasible, although safety data are lacking. The objective of this study was to evaluate the impact of a home O(2) clinical care protocol on admission rates in patients with bronchiolitis from the pediatric emergency department. ⋯ Home O(2) is an effective way to decrease hospital admissions in a select group of patients with bronchiolitis.